Can Poor Diet & Lack of Exercise Cause Diabetes?

There are two types of diabetes (type 1 & type 2) that are caused by different factors in the human body. The symptoms in both types of diabetes are similar, although sometimes symptoms for type 2 diabetes are non-existent or develop over a long period of time. Type 1 diabetes is believed by scientists to be caused by genetic or environmental factors like exposure to viruses. Type 2 diabetes, which is the most common type of diabetes, is generally caused by lifestyle factors.

In this article, we take a look at data in each US state for two lifestyle factors, diet and exercise, and compare the data to the percentage of diagnosed diabetics per state. The data suggest a positive correlation for diet (consumption of less than 1 fruit & vegetable daily) and lack of exercise (no physical activity or exercise) and diagnosed diabetics.

Diagnosed Diabetics Per State Data

For our analysis, we use data from the Centers for Disease Control (CDC)¹ on how many people in every state have diabetes. The data includes respondents that are adults (age of 18 or older) and have been told by a healthcare professional that they have diabetes. The CDC counts all types of diabetes together (Type 1 & Type 2, excluding women who had diabetes only during pregnancy). You can view the CDC data for an interactive experience with comprehensive diabetes data and how its changed over time at a national, state, and county level here: https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html

Below is a US map that highlights the percentage of diagnosed diabetics per CDC data.

_{Percentages of diagnosed diabetics are based on data from https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html}

Looking at the data for diagnosed diabetics per state for adults aged 18 or older in the most recent surveyed year (2020), we find that Guam has the highest percentage of diagnosed diabetics (16.6%). States that follow are Puerto Rico (13.3%), West Virginia (13.1%), and Mississippi (13.1%). The states with lowest percentage of adult diagnosed diabetics are Vermont (6.7%), North Dakota (7.0%), Colorado (7.1%), and Alaska (7.1%).

Comparing Lifestyle Factors to Diabetes

When researchers look at the number of people with diabetes in a state or country, this population-level data can also help them find what increases a person’s risk for diabetes. You can think of it this way. If 50 people go to a new buffet restaurant and 40 of them get food poisoning the next day, the food at the restaurant might have made them sick. Not everyone in the town who has food poisoning went to this restaurant and not everyone who went to the restaurant has food poisoning. In this example, going to the restaurant is a risk factor for food poisoning.

Risk factors for diabetes include a diet high in refined sugars and fats, overweight or obesity, and inactivity or having a sedentary lifestyle that involves a lot of sitting and not much exercise. For instance, the people of Guam report eating a lot of white rice and sweetened drinks.³ Around 36% of people in Guam are obese. Both diet and weight are risk factors for diabetes, which might help explain why Guam has so many people with diabetes.

In contrast, Vermont has fewer overweight people (26%),⁴ and there is an emphasis on year-round exercise. Around 80% of people in Vermont reported exercising for fun in the last 30 days.⁵

Comparing data for states with lower daily consumption of fruit and vegetables (less than 1 time daily), we see a positive correlation with the percentage of diagnosed diabetic in these states.

For example, in Puerto Rico the data shows that less than one daily consumption of fruit is 53.3% of the respondents and 44.4% for vegetable consumption. The percentage of diagnosed diabetics in Puerto Rico is 13.3%, which is higher than the national average (9.4%) and 2nd highest overall in the US. Comparing this to Vermont which has the lowest percentage of diagnosed diabetics (6.7%), the data shows Vermont respondents consuming less than one fruit daily is 32% and vegetables is 12.7%.

To get a closer look at the comparative data across all states, view the graph below to see the correlation between diet (daily consumption of less than 1 fruit and vegetable) and inactivity levels (no exercise or physical activity in the past month) and a higher percentage of diabetics in the state.

The trendlines show that as the percentage increases for respondents that consumed less than 1 fruit or vegetable daily and had no physical activity or exercise outside work; so does the percentage of diagnosed diabetics in that state.

Survey data for fruit and vegetable diet consumption and activity levels were collected from the CDC website.

Research has shown that 30 minutes of walking or other low-intensity exercise on a daily basis, combined with a low-fat diet, can reduce the risk of developing type 2 diabetes by 58%. Exercise helps to lower blood sugar levels by your muscle cells being more efficient at taking up glucose and using it as energy during and after exercise. This can help lower your blood sugar levels.

While exercise can help reduce glucose levels in the body, it is also important to note the amount of fats, calories, and cholesterol that we intake. Carbohydrates can be healthy, however, high carb consumption can cause blood glucose to be too high. The body cannot use enough of the glucose for energy. This is why diets high in fiber (darker vegetables, leafy greens) can help to balance your diet and help prevent or control the effects of diabetes.

Things like diet, exercise, and weight are considered modifiable risk factors – these are things a person can change about themselves, even though it can be difficult. Nonmodifiable risk factors include things like race, ethnicity, sex, genetics, and, sometimes, education and income. Both types of risk factors influence how likely a person is to have diabetes.⁴

Common Complications With Diabetes

Some surveys also measured how often people with diabetes have certain problems, like foot pain or numbness from neuropathy or poor circulation, foot ulcers or sores, or even amputation (removal of the foot or toe).

In 2008, nearly 30% of people with diabetes also had a foot problem. Of those, 55% were over age 65. As many as 15% of people with diabetes may have an amputation of a foot or toe because of diabetes in their lifetime.⁵

There are a few keys to preventing foot ulcers and amputation.

• Keep your blood sugar and A1C numbers in range with your doctor’s recommendations.
• See a healthcare provider regularly and have them check your feet.
• Use adequate shoes and footwear. See the offerings here at flowfeet.com for some great options!

References

1. Centers for Disease Control and Prevention. Diabetes data and statistics. CDC.gov. https://www.cdc.gov/diabetes/data.

2. U. S. Census Bureau. Quickfacts: California. Census.gov. https://www.census.gov/quickfacts/fact/table/CA/PST040221

3. Guerrero RTL, Paulino YC, Novotny R, Murphy SP. Diet and obesity among Chamorro and Filipino adults on Guam. Asia Pac J Clin Nutr. 2008;17(2):216-222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762033/

4. Centers for Disease Control and Prevention. New adult obesity maps. CDC.gov. https://www.cdc.gov/obesity/data/prevalence-maps.html

5. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008;88(11):1254-1264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870323/

About author:

Dr. Lauren Wheeler is a full-time medical writer with training and experience as a family medicine physician. She loves creating well-researched, helpful patient and provider education.